Emotional and behavioral disorders

"Emotional disability" redirects here. For other mental disorders, see Emotional disabilities.

Emotional and behavioral disorders
Classification and external resources
Specialty
ICD-10	F90–F98
ICD-9-CM	312
Patient UK	Emotional and behavioral disorders

Emotional and behavioral disorders (EBD; sometimes called emotional disturbance or serious emotional disturbance) refer to a disability classification used in educational settings that allows educational institutions to provide special education and related services to students that have poor social or academic adjustment that cannot be better explained by biological abnormalities or a developmental disability. The classification is often given to students that need individualized behavior supports to receive a free and appropriate public education, but would not be eligible for an individualized education program under another disability category of the Individuals with Disabilities Education Act (IDEA).

Diagnostic criteria

The IDEA requires that a student must exhibit one or more of the following characteristics over a long duration, and to a marked degree that adversely affects their educational performance, to receive an EBD classification:

• Difficulty to learn that cannot be explained by intellectual, sensory, or health factors.
• Difficulty to build or maintain satisfactory interpersonal relationships with peers and teachers.
• Inappropriate types of behavior (acting out against self or others) or feelings (expresses the need to harm self or others, low self-worth, etc.) under normal circumstances.
• A general pervasive mood of unhappiness or depression.
• A tendency to develop physical symptoms or fears associated with personal or school problems.

The term "EBD" includes students diagnosed with schizophrenia, but does not apply to students who are "socially maladjusted", unless it is determined that they also meet the criteria for an EBD classification.

Criticisms of diagnostic criteria

Providing or failing to provide an EBD classification to a student may be controversial, as the IDEA does not clarify which children would be considered "socially maladjusted", but ineligible for an individualized education program under an EBD classification. Some states do not allow students with a psychiatric diagnosis of conduct disorder to receive additional educational services under an EBD classification, although many students with an EBD classification do meet the diagnostic criteria for various disruptive behavior disorders, including attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), or conduct disorder (CD). Additionally, students considered "socially maladjusted", but ineligible for an EBD classification (i.e., students diagnosed with conduct disorder), often receive better educational services in special education classrooms or alternative schools with high structure, clear rules, and consistent consequences, which they would not receive in general education settings. The ambiguous guidelines for determining what students are "socially maladjusted", but without EBD, may cause many students that would benefit from special education services to receive less effective educational services.

Student characteristics

Students with EBD are a diverse population, and have a wide range of intellectual and academic abilities. Males, African-Americans, and economically disadvantaged students are overrepresented in the EBD population, and students with EBD are more likely to live in single-parent homes, foster homes, or other non-traditional living situations. They also tend to have low rates of positive social interactions with students and peers in instructional contexts, and many have one or more comorbid psychiatric diagnoses. Students with EBD are often categorized as "internalizers" (e.g., have poor self-esteem, or are diagnosed with an anxiety disorder or mood disorder) or "externalizers" (e.g., disrupt classroom instruction, or are diagnosed with disruptive behavior disorders such as oppositional defiant disorder and conduct disorder). Male students may be overrepresented in the EBD population because they tend to exhibit disruptive externalizing behavior that interferes with classroom instruction, whereas females more commonly exhibit internalizing behavior that does not interfere with classroom instruction; thus, teachers may refer males for special education services more often than females. Students with EBD are also at an increased risk for learning disabilities, school dropout, substance abuse, and juvenile delinquency.

Internalizing and externalizing behavior

A person with EBD with "internalizing" behavior may have poor self-esteem, suffer from depression, experience loss of interest in social, academic, and other life activities, and may exhibit non-suicidal self-injury or substance abuse. Students with internalizing behavior may also have a diagnosis of separation anxiety or another anxiety disorder, post-traumatic stress disorder (PTSD), specific or social phobia, obsessive–compulsive disorder (OCD), panic disorder, and/or an eating disorder. Some research suggests students with EBD with internalizing behavior are underdiagnosed; teachers are more likely to write referrals for students that are overtly disruptive, and screening tools to detect students with high levels of internalizing behavior are not sensitive and are rarely used in practice.

Students with EBD with "externalizing" behavior may be aggressive, noncompliant, extroverted, or disruptive, and generally "act out" inappropriately. Students with EBD that show externalizing behavior are often diagnosed with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), conduct disorder, and/or bipolar disorder; however, this population can also include typically developing children that have learned to exhibit externalizing behavior for various reasons (e.g., escape from academic demands or access to attention). These students often have difficulty inhibiting emotional responses resulting from anger, frustration, and disappointment, and may exhibit behaviors such as insulting, provoking, threatening, bullying, cursing, and fighting, along with other forms of aggression; noncompliance with and disrespect towards teachers and other authority figures is also common. Male students with EBD exhibit externalizing behavior more often than their female counterparts.

External links

• What is an emotional or behavioral disorder?
• Behaviour Management (EBD) Review Group: Published reviews
• Intervention Central